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向新晋医生传授超声引导下的静脉置管技术

Teaching Ultrasound-Guided Venous Cannulation to Newly Qualified Doctors.

作者信息

Gleeson Joseph J, Boal Hayley, Sharp Thomas, Morris Rebecca

机构信息

Medical Education and Simulation, The Mid Yorkshire Teaching NHS Trust, Wakefield, GBR.

出版信息

Cureus. 2024 Apr 15;16(4):e58295. doi: 10.7759/cureus.58295. eCollection 2024 Apr.

Abstract

Background Venous cannulation is an essential task that allows the intravenous administration of fluids and medications. In the United Kingdom, this task is often performed by newly qualified Foundation Year 1 (FY1) doctors; however, difficulties are commonly encountered. The usage of ultrasound increases the chance of successful cannulation, provided the operator has been trained. Some medical schools now include ultrasound in their undergraduate curricula, though this is far from universal. Methods Forty-eight FY1s received a one-hour teaching session on ultrasound-guided venous cannulation, delivered by near-peer Education Fellows. FY1s completed questionnaires immediately after the teaching session, and a follow-up questionnaire three months later. Findings 44.44% of FY1s felt "fairly" or "very" confident in ultrasound-guided venous cannulation at follow-up, compared to 6.66% before the session. Sixty-three attempts were made in the month before the follow-up survey, compared to six in the month prior to the teaching session. The success rate at follow-up was 60% (38/63), up from 50% (3/6) prior to the session. One third fewer cannulas were escalated to senior doctors (72 vs 48), although there was little change in escalations to anesthetists, from 15 vs 18. FY1s identified the lack of ultrasound machines on the wards as a barrier to using ultrasound-guided venous cannulation more often. Conclusion A short, near-peer teaching session can improve FY1s' confidence, usage, and success rates in ultrasound-guided venous cannulation.

摘要

背景

静脉置管是一项重要操作,可实现静脉输液和给药。在英国,这项操作通常由新获得资格的一年级住院医生(FY1)执行;然而,他们常常遇到困难。如果操作人员经过培训,使用超声可增加置管成功的几率。现在一些医学院校已将超声纳入本科课程,但这远未普及。

方法

48名FY1接受了由同侪教育研究员进行的为期一小时的超声引导静脉置管教学。FY1在教学结束后立即填写问卷,并在三个月后填写一份随访问卷。

结果

随访时,44.44%的FY1对超声引导静脉置管感到“比较”或“非常”自信,而在教学前这一比例为6.66%。随访调查前一个月进行了63次置管尝试,而教学前一个月为6次。随访时的成功率为60%(38/63),高于教学前的50%(3/6)。升级到上级医生处理的置管减少了三分之一(72次对48次),不过升级到麻醉医生处理的次数变化不大,从15次对18次。FY1认为病房缺少超声设备是更频繁使用超声引导静脉置管的障碍。

结论

一次简短的同侪教学可提高FY1在超声引导静脉置管方面的信心、使用率和成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9df2/11094656/f28bbb551c51/cureus-0016-00000058295-i01.jpg

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